Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium
Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium
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DOI：
10.1177/2047487319877078
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发表时间：
2019-10-16
影响因子：
8.3
通讯作者：
Thompson, Simon G.
中科院分区：
文献类型：
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作者：
Bahls, Martin;Lorenz, Matthias W.;Thompson, Simon G.
平均测量值，而不是基于颈动脉内膜中层厚度（cIMT）的多重评估的进展，是个体心血管疾病（CVD）事件的预测。这是否是真的传统的风险factors.Methods和结果一个单独的参与者荟萃分析被用来关联的收缩压，总胆固醇，低密度脂蛋白胆固醇和高密度脂蛋白胆固醇与未来的心血管疾病的风险在13个前瞻性队列研究的PROG-IMT协作（n = 34,072）的年度进展。随访数据包括心肌梗死、卒中或血管性死亡等心血管疾病联合终点的信息。在次要分析中，用平均值替换年进展。通过随机效应荟萃分析，汇总了各项研究中每个标准差的对数风险比。在主要分析中，总胆固醇的年化进展与较高的心血管疾病风险略微相关（风险比（HR）1.04，95%置信区间（CI）1.00 - 1.07）。收缩压、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇的年化进展与未来心血管疾病风险无关。次要分析中，平均收缩压（HR 1.20 95% CI 1.11 - 1.29）和低密度脂蛋白胆固醇（HR 1.09，95% CI 1.02至1.16）与较高的，而高密度脂蛋白胆固醇（HR 0.92，95%CI 0.88 - 0.97）与未来心血管疾病事件的风险降低有关。低密度脂蛋白胆固醇和高密度脂蛋白胆固醇与未来心血管疾病事件的风险呈显著的线性关系。然而，这些传统风险因素的年化进展与未来临床终点的风险之间没有明确的相关性。
Aims Averaged measurements, but not the progression based on multiple assessments of carotid intima-media thickness, (cIMT) are predictive of cardiovascular disease (CVD) events in individuals. Whether this is true for conventional risk factors is unclear.Methods and results An individual participant meta-analysis was used to associate the annualised progression of systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with future cardiovascular disease risk in 13 prospective cohort studies of the PROG-IMT collaboration (n = 34,072). Follow-up data included information on a combined cardiovascular disease endpoint of myocardial infarction, stroke, or vascular death. In secondary analyses, annualised progression was replaced with average. Log hazard ratios per standard deviation difference were pooled across studies by a random effects meta-analysis. In primary analysis, the annualised progression of total cholesterol was marginally related to a higher cardiovascular disease risk (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.00 to 1.07). The annualised progression of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol was not associated with future cardiovascular disease risk. In secondary analysis, average systolic blood pressure (HR 1.20 95% CI 1.11 to 1.29) and low-density lipoprotein cholesterol (HR 1.09, 95% CI 1.02 to 1.16) were related to a greater, while high-density lipoprotein cholesterol (HR 0.92, 95% CI 0.88 to 0.97) was related to a lower risk of future cardiovascular disease events.Conclusion Averaged measurements of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol displayed significant linear relationships with the risk of future cardiovascular disease events. However, there was no clear association between the annualised progression of these conventional risk factors in individuals with the risk of future clinical endpoints.